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Basic EMS Glossary

This is not going to be a medical dictionary. One can easily find a dictionary for all of the medical terms used in EMS. Many of them are used on television shows all the time. But there appears to be a few terms, that when used by emergency workers and heard by reporters that cause confusion. For example, just the other day, I heard a television reporter refer to the criteria for not starting CPR on a person as, "When there is decomposition, decapitation, rigor mortis, or the family is upset." The last criteria was their misinterpretation of the word "lividity." They probably used the definition of this as "the state of being livid" which most people think is about being upset.

AED, Automated External Defibrillator- An automatic device for the defibrillation of patients suffering from a convertible heart rhythm. It is "automatic" in the sense that the user does not need to be able to read or interpret heart rhythm on the ECG. The device will often have a voice that says "Shock now." the operator only has to stand back and press one button.

Advanced Life Support (ALS) - Medical care provided by paramedics. This includes the administering of medications, defibrillation and providing advanced airway management prior to transportation to the hospital. This is much like the treatment the patient would receive in the hospital ER.

A&O X 3 - ("Alert and oriented times three") - Basically the patient knows "who they are" "where they are" and when they are. I once had a patient know their name, where they were, and that the president was Richard Nixon. Unfortunately, this was in 1989. Our next question was "What year is this?" He confidently answered "1973". That is why we ask such dumb questions.

Basic Life Support (BLS) - This is what an EMT can provide.

Box - Slang term for MICU. Appears to be used by many departments. "I'm on the 'box' today." Means, "Today is my opportunity to be assigned to the MICU, thanks to the fair and pleasant rotation schedule implemented by our illustrious and wise station officer."

ETOH - Ethane (C2H4) is abbreviated as "ET". If a Hydroxyl group (OH) is added it becomes C2H4O, or Ethanol. This is commonly known as "drinking alcohol". If you hear a paramedic say "ETOH on board" you can guess what is being said.

Frequent Flyer - Someone who uses the EMS system often. This can be someone who often abuses the system by calling for an ambulance, who really doesn't need one. But more often it is someone with a persistent medical condition who frequently really needs assistance. It isn't a derogatory term as much as just a description of someone we see often.

Lividity / Postmortem Lividity / Livor Mortis - A condition where the blood pools, due to being uncirculated, in the lower (dependant) parts of the body. This causes a dark red to purple discoloration. It is often used as a sign that the patient is no longer revivable and is pronounced dead. CPR can usually be stopped if this condition is found. Note: This comes from the term "livid" which does not just mean "very angry" but rather so upset that the face turns red. Lividity can mean any unnatural color of skin, this can be from a bruise, for example. While EMS workers will simply say "lividity" what we really mean is postmortem lividity. More info: http://en.wikipedia.org/wiki/Livor_mortis

LOC / No LOC / No ΔLOC - Unfortunately this abbreviation has different meanings in various systems and parts of the country. This can mean "loss of consciousness" or "level of consciousness". If someone says "No LOC" they probably mean that there was no loss of consciousness. If they write on their form "No Δ LOC" they probably meant that there was no change (Δ) in the level of consciousness.

MICU - (Mobile Intensive Care Unit) This is what many people mistakenly refer to as an “ambulance”. Many fire departments will still write the word “ambulance” on these vehicles because people expect it. A MICU is capable of Advanced Life Support (ALS). In the past, the job of the ambulance was to transport the patient to medical care as soon as possible. The term "ambulance" comes from the word "ambulate" which means "to move about". Today the goal is to bring advanced medical care to the patient as quickly as possible. With the exception of some procedures, such as blood replacement, surgery and some lab tests, the paramedics on the MICU can perform just about any procedure you would get at a hospital emergency department in the first thirty minutes of care. There are some variations on the name of this vehicle. In Canada they may be labeled, "Advance Life Support Ambulance, Ministry of Health". You might also see "ALS Ambulance" on the sides of vehicles.

MVA / MVC - Several definitions exist, but they all mean the same thing. "Motor Vehicle Accident", "Major Vehicle Accident", "Motor Vehicle Collision", "Major Vehicle Collision". Some areas are wanting to change to the "MVC" term because they feel that "MVA" suggests a determination of fault (or lack there of) while MVC does not have a connotation of no one at fault.

PERLA - Pupils Equal and Reactive to light Appropriately.

POPTA - Passed Out Prior To our Arrival.

TKO - "To Keep Open" Also known by some other abbreviations. This is an IV line for the purpose of keeping open a route for drug administration. This is usually a just precautionary action. In many areas a "Hep-lock" has taken the place of a full IV.

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